The DPQC is part of the Delaware Healthy Mothers Infant Consortium (DHMIC) that provide statewide leadership and coordination of efforts to prevent infant mortality and to improve the health of women of childbearing age and infants throughout Delaware. DPQC is a comprehensive collaboration of perinatal health-related practitioners from a variety of professions and specialties, statewide organizations, individuals, advocates, educators, policymakers, hospitals and payers. These stakeholders work voluntarily to implement quality improvement projects and provide evidence-based perinatal care to promote better outcomes for mothers and babies in in Delaware.
The DPQC was created to improve Delaware’s maternal and infant health outcomes through the delivery of continuous, data-driven, population-based, quality improvement initiatives with a focus on some of the most critical perinatal health issues affecting women and children.
QI initiatives are multidisciplinary, systems-focused, data-driven methods of understanding and improving the efficiency, effectiveness and reliability of health processes and care outcomes. QI initiatives are utilized to reduce quality gaps (differences between health care processes or outcomes observed in practice and those potentially obtainable based on current evidence-based knowledge) for groups of patients.*
*Agency for Healthcare Research and Quality, 2004.
The DPQC’s seeks to create a culture of collaboration across the six birthing hospitals in Delaware. DPQC realizes this culture of collaboration through cooperation and transparency across the perinatal health providers and specialties that include obstetrics, maternal-fetal medicine, neonatology, pediatrics, and stakeholders engaged in improving maternal and infant health (i.e., public health) care by bringing together the specific expertise of physicians, epidemiologists, nurses, nurse-midwives, quality improvement experts and all other practitioners involved in perinatal health outcomes.
DPQC uses participating hospitals discharge data (i.e., hospitalization or hospital discharge, refers to any discharge from a non-federal, short-stay, acute-care hospital in Delaware expressed as discharges for a single patient who may have multiple hospitalizations) for all inpatient hospitalizations in Delaware to develop key performance indicators (KPIs) for women of reproductive age (12-51 years) and infants up to one year of age.
The “Who, What, Why, When, Where, and How” of the DPQC Data
- Who are the data about (who is being observed/measured)? Women of reproductive age 12 to 51 years of age at the time of admission and infants who were born and/or transferred to the admitting facility up to one year of age at the time of admission.
- What are the data about (what is being observed/measured)? All individual inpatient hospitalizations for women of reproductive age 12 to 51 years of age at the time of admission and infants who were born and/or transferred to the admitting facility up to one year of age at the time of admission. Hospitalization information contains information on the entire episode of care (including date of admission and date of discharge, admitting diagnosis, principal diagnosis, secondary, tertiary, and other diagnosis, principal procedures, secondary, tertiary, and other procedures).
- Why are the data collected (Purpose)? DPQC utilizes the data from participating hospitals to develop KPIs for initiating and implementing quality improvement activities, training and resources to participating hospitals to improve perinatal outcomes.
- When and where is the data collected/stored? Participating hospitals collect the hospital discharge data as part of Uniform Billing (UB-04/UB 82) to CMS submission and the data are typically housed within their Health Information Management System (HIMS) and/or Medical Records data warehouse. Data are expected to be stored based on the recommended vendor identified by DPQC that is HIPAA compliant.
- How frequently are the data need to be submitted? DPQC expects the data to be on a quarterly basis as is currently the case with hospitals submitting the data to the state as per Title 16 Ch.20 § 2004 requirements. Since the data for DPQC are a subset of the larger dataset, it is anticipated that quarterly submissions of data will allow timely intervention for improving quality of care.
- Who are the signatories and who can access the data? All participating hospitals through a Memorandum of Understanding (MOU) are signatories. As of this writing two hospitals have signed the MOUs. The KPIs developed is anticipated to be shared through dashboards for all signatories and their respective teams. The Chair of DPQC and/or his/her designee will authorize who can access and/or view the data and KPIs.
- How will the data be protected? All participating hospitals who have signed MOUs will review the DPQC recommended vendor capabilities for ensuring that it meets their security policies. As of this writing 3 of the six hospitals have reviewed the DPQC vendor capabilities through their internal review.